<div class="portlet x4">
			
			<div class="portlet-header">
				<h4>Personal Details</h4>
			</div> <!-- .portlet-header -->
			
			<div class="portlet-content">
				
				<form id="add-user-form" action="#" method="get" class="form label-top">
					
					<div class="field"><label for="fname">Name </label> <input id="fname" name="fname" size="10" type="text" value="First Name" /><input id="lname" name="lname" size="15" type="text" value="Last Name" /></div>
					
					<div class="field"><label for="email">Email </label> <input id="email" name="email" size="35" type="text" class="medium" /></div>
					
					<div class="field phone_field">
						<label for="lname">Phone </label> 
						
						<input id="phone1" name="phone1" size="3" type="text" /> -
						<input id="phone2" name="phone2" size="5" type="text" /> -
						<input id="phone3" name="phone3" size="5" type="text" />
						
						
					</div>
					
					
					<div class="controlset field">
						<span class="label">Department</span>

						
						<div class="controlset-pad">
						<input name="radio1" id="radio1" value="1" type="radio" /> <label for="radio1">Accounting</label><br />
						<input name="radio1" id="radio2" value="1" type="radio" /> <label for="radio2">Engineering</label><br />
		
						<input name="radio1" id="radio3" value="1" type="radio" /> <label for="radio3">Finance</label><br />
						<input name="radio1" id="radio4" value="1" type="radio" /> <label for="radio4">Sales</label><br />
						</div>
					</div>	
					
					<div class="buttonrow">
						<button class="btn btn-orange">Add User</button>
					</div> 		
				
					
				</form>
				
			</div> <!-- .portlet-content -->
			
		</div> <!-- .portlet -->

	</div> <!-- #content -->
<div id="footer">
		
		<p>Copyright &copy; 2012 <a href="http://elektro.unsyiah.ac.id/staf/smuchallil">Sayed Muchallil</a>, all rights reserved.</p>
		
	</div> <!-- #footer -->
	
</div> <!-- #wrapper -->

</body>
</html>